Provider Demographics
NPI:1144984626
Name:FLOSSOPHY DENTAL HYGIENE
Entity type:Organization
Organization Name:FLOSSOPHY DENTAL HYGIENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL HYGIENIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HENDERHOT
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:303-525-5870
Mailing Address - Street 1:1524 ASHCROFT DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6824
Mailing Address - Country:US
Mailing Address - Phone:303-525-5870
Mailing Address - Fax:
Practice Address - Street 1:2350 17TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-1738
Practice Address - Country:US
Practice Address - Phone:303-525-5870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental